States from coast to coast and national healthcare organizations have proposed legislation to lessen restrictions placed on advanced practice providers when providing care — but not everyone is on board.
The pandemic, burnout and physician pay cuts have led to an exodus of healthcare workers, and more than 2 in 5 active physicians will be older than 65 in the next decade.
In the face of a looming shortage of providers, some healthcare workers believe reducing limitations placed on physician assistants' and nurse practitioners' will provide relief.
"In this country, 99 million Americans lack adequate access to primary care," Jennifer Orozco, president and board chair of the American Academy of Physician Associates, told Becker's. "We have an aging population that is going to reach 80.8 million by 2040. In addition, we have a rise in chronic diseases like obesity. The reality is, unless we remove these barriers to physician assistant practice, we do not have enough people to take care of all patients."
South Carolina legislators have introduced a bill to allow physician assistants with 6,000 hours of training to practice without the supervision of a physician.
Jennifer Marshall and Megan Fulton, co-chairs of the legislative committee of the South Carolina Academy of Physician Assistants, said the legislation is key to address the growing shortage of physicians.
"There are not enough physicians to see patients, [which] also means it can be difficult to identify a supervising physician, which severely limits the ability for physician assistants to provide care in rural areas," Ms. Marshall and Ms. Fulton told Becker's. "The ability for physician assistants with 6,000 hours of experience to see patients without requiring a supervising physician will remedy these challenges."
However, some physicians — and potentially their patients — are concerned that physician assistants and nurse practitioners are not adequately prepared to operate independently. A Medscape survey of physicians found that 27 percent of providers said their patients were "somewhat to very" opposed to nurse practitioners and physician assistants working without supervision.
"The nurse practitioners and physician assistants I work with [and have seen as a patient] have been very capable, but it is just not the case that after four years of med school, including two in clinical work, and four years as a practicing (but supervised) psychiatrist, the clinical care I provide is equivalent to that of an NP/PA," Lance Wobus, MD, a psychiatry resident at Richmond University Medical Center in New York City, told Becker's. "I think this trend will also be detrimental to healthcare."
James Alexander, MD, chief medical officer of Integritas Providers in Carbondale, Ill., said increasing medical liberties could backfire on patients and providers.
"With that comes more responsibility and liability," Dr. Alexander told Becker's. "I seriously doubt advanced practice providers pay more than the average internal medicine or pediatric provider for malpractice coverage."